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Differentiation of desquamative interstitial pneumonia (DIP) from pulmonary adenocarcinoma by immunocytochemistry
A E Mutton1, P S Hasleton, A Curry
1Department of Histopathology, Wythenshawe Hospital, Manchester, UK.
Aim:
After a misdiagnosis of pulmonary adenocarcinoma as desquamative interstitial pneumonia (DIP), we investigated whether immunohistochemical markers could differentiate these conditions.
Methods And Results:
Three cases of DIP and one pulmonary adenocarcinoma masquerading as DIP were studied by light and electron microscopy. All cases were mucin-negative. The cases of DIP were CD68 positive but cytokeratin-negative. The adenocarcinoma was cytokeratin-positive (AE1/3 and CAM5.2), as well as showing some CD68-positive cells. Markers for carcinoma (CEA, Ber-EP4, and Leu M1) were negative in all cases. Ultrastructurally the adenocarcinoma appeared to be derived from Type II pneumocytes.
Conclusion:
Before a diagnosis of DIP is made, cytokeratin markers should be used.